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Nash K, Gwynne K, Dimitropoulos Y, Fitzpatrick M, Gunasekera H, Halvorsen L, Kong K, Lumby N, Macniven R, Parter C, Wingett A, McMahon C. INdigenous Systems and Policies Improved and Reimagined for Ear and hearing care (INSPIRE): a multi-method study protocol. BMJ Open 2024; 14:e079850. [PMID: 38199621 PMCID: PMC10806583 DOI: 10.1136/bmjopen-2023-079850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/05/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Otitis media (middle ear disease) severity and chronicity among Aboriginal and Torres Strait Islander people, as well as gaps in socioeconomic outcomes related to hearing loss, indicates a breakdown in the current ear and hearing care system. The ear and hearing care system spans multiple sectors due to long-term impacts of otitis media and hearing loss in health, education and employment, necessitating a multi-disciplinary cross-sectorial approach to ear and hearing care. Public policies shape the current ear and hearing care system and here it is argued that a critical public policy analysis across different sectors is needed, with strong Aboriginal and Torres Strait Islander leadership and guidance. The current study aims to establish consensus-based ear and hearing care policy solutions for Aboriginal and Torres Strait Islander people in Australia. METHODS AND ANALYSIS This multi-method study will be guided by a Brains Trust with strong Aboriginal and Torres Strait Islander leadership. Public policies in hearing health, social services, and education will be scoped to identify policy gaps, using the World Health Organization framework. Qualitative data will be collected through a culturally specific process of yarning circles to identify policy challenges and/or limitations in enabling accessible ear and hearing care programs/services for Aboriginal and Torres Strait Islander people, using dimensions of Morestin's public policy appraisal tool as an interview guide for stakeholders. Themes from the yarning circles will be used to inform an expert Delphi process to establish consensus-based policy solutions for optimising the ear and hearing care system for Aboriginal and Torres Strait Islander people. ETHICS AND DISSEMINATION This study has approval from the Australian Institute of Aboriginal and Torres Strait Islander Studies Ethics Committee. Study findings will be disseminated to community through Brains Trust members and study participants, as well as through publications in peer-reviewed journals and research forum presentations.
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Affiliation(s)
- Kai Nash
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Kylie Gwynne
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Yvonne Dimitropoulos
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Mark Fitzpatrick
- Telethon Speech and Hearing, Perth, Western Australia, Australia
| | | | - Luke Halvorsen
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Kelvin Kong
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
| | - Noeleen Lumby
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Rona Macniven
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Carmen Parter
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Amanda Wingett
- College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Catherine McMahon
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
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Constantinides F, Orr N, Nash K, Evans JR, McMahon CM, Gunasekera H, Harkus S, Clague L, Cross C, Halvorsen L, Lumby N, Coates H, Macniven R. Examining relationships between parent-reported factors and recurring ear symptoms among Aboriginal and Torres Strait Islander children. Health Promot J Austr 2024; 35:225-234. [PMID: 36961054 DOI: 10.1002/hpja.719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 02/14/2023] [Accepted: 03/20/2023] [Indexed: 03/25/2023] Open
Abstract
ISSUE ADDRESSED Aboriginal and Torres Strait Islander child ear health is complex and multiple. We examined relationships between parent-reported sociodemographic, child health, health service access factors and ear symptoms among Aboriginal and Torres Strait Islander children aged 3 to 7 years. METHODS The Longitudinal Study of Indigenous Children is a large child cohort study with annual parent-reported data collection. Generalised linear mixed model analyses examined Wave 1 (1309 children 0-5 years; 2008) predictors of being free of parent-reported ear symptoms in both Waves 2 and 3. RESULTS A total of 1030 (78.7%) had no reported ear symptoms in either Wave 2 or 3. In the fully adjusted model, children who had been hospitalised in the past year (aOR = 2.16; 95% CI 1.19-3.93) and those with no ear symptoms (aOR = 2.94; 95% CI, 1.59-5.46) at Wave 1 had higher odds of no ear symptoms in both the subsequent waves. There were also relationships between parent main source of income-government pension or allowance as well as parents who reported no history of their own ear symptoms and higher odds of no ear symptoms in Waves 2 and 3 after partial adjustment for sociodemographic factors. CONCLUSION These findings suggest relationships between different sociodemographic and health factors and parent-reported ear symptoms among Aboriginal and Torres Strait Islander children that warrant further investigation. So what? Children with parent-reported ear symptoms during the early years need holistic support to prevent future ear symptoms that impact health, social and educational life trajectories.
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Affiliation(s)
- Fina Constantinides
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Neil Orr
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Kai Nash
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - John Robert Evans
- Moondani Toombadool Centre, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Catherine M McMahon
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Hasantha Gunasekera
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Children's Hospital Westmead Clinical School, Sydney, New South Wales, Australia
| | - Samantha Harkus
- National Acoustic Laboratories, Macquarie University, Sydney, New South Wales, Australia
| | - Liesa Clague
- School of Nursing and Midwifery, University of Notre Dame, Sydney, New South Wales, Australia
| | - Cara Cross
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Luke Halvorsen
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Noeleen Lumby
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Harvey Coates
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Rona Macniven
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
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Nash K, Macniven R, Clague L, Coates H, Fitzpatrick M, Gunasekera H, Gwynne K, Halvorsen L, Harkus S, Holt L, Lumby N, Neal K, Orr N, Pellicano E, Rambaldini B, McMahon C. Ear and hearing care programs for First Nations children: a scoping review. BMC Health Serv Res 2023; 23:380. [PMID: 37076841 PMCID: PMC10116763 DOI: 10.1186/s12913-023-09338-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/24/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Ear and hearing care programs are critical to early detection and management of otitis media (or middle ear disease). Otitis media and associated hearing loss disproportionately impacts First Nations children. This affects speech and language development, social and cognitive development and, in turn, education and life outcomes. This scoping review aimed to better understand how ear and hearing care programs for First Nations children in high-income colonial-settler countries aimed to reduce the burden of otitis media and increase equitable access to care. Specifically, the review aimed to chart program strategies, map the focus of each program against 4 parts of a care pathway (prevention, detection, diagnosis/management, rehabilitation), and to identify the factors that indicated the longer-term sustainability and success of programs. METHOD A database search was conducted in March 2021 using Medline, Embase, Global Health, APA PsycInfo, CINAHL, Web of Science Core Collection, Scopus, and Academic Search Premier. Programs were eligible or inclusion if they had either been developed or run at any time between January 2010 to March 2021. Search terms encompassed terms such as First Nations children, ear and hearing care, and health programs, initiatives, campaigns, and services. RESULTS Twenty-seven articles met the criteria to be included in the review and described a total of twenty-one ear and hearing care programs. Programs employed strategies to: (i) connect patients to specialist services, (ii) improve cultural safety of services, and (iii) increase access to ear and hearing care services. However, program evaluation measures were limited to outputs or the evaluation of service-level outcome, rather than patient-based outcomes. Factors which contributed to program sustainability included funding and community involvement although these were limited in many cases. CONCLUSION The result of this study highlighted that programs primarily operate at two points along the care pathway-detection and diagnosis/management, presumably where the greatest need lies. Targeted strategies were used to address these, some which were limited in their approach. The success of many programs are evaluated as outputs, and many programs rely on funding sources which can potentially limit longer-term sustainability. Finally, the involvement of First Nations people and communities typically only occurred during implementation rather than across the development of the program. Future programs should be embedded within a connected system of care and tied to existing policies and funding streams to ensure long term viability. Programs should be governed and evaluated by First Nations communities to further ensure programs are sustainable and are designed to meet community needs.
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Affiliation(s)
- Kai Nash
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia.
| | - Rona Macniven
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Liesa Clague
- Thurru Indigenous Unit, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Harvey Coates
- The University of Western Australia, Perth, Australia
| | | | | | - Kylie Gwynne
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | - Luke Halvorsen
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | | | - Leanne Holt
- Department of Indigenous Studies, Macquarie University, Sydney, Australia
| | - Noeleen Lumby
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | | | - Neil Orr
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | | | - Boe Rambaldini
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | - Catherine McMahon
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
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Salins A, Nash K, Macniven R, Halvorsen L, Lumby N, McMahon C. Culturally safe speech-language supports for First Nations children: Achieving Sustainable Development Goals 3, 4, 8 and 10. Int J Speech Lang Pathol 2023; 25:152-156. [PMID: 36412077 DOI: 10.1080/17549507.2022.2143565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
PURPOSE Self-determination is foundational to health and well-being for First Nations people. Colonisation has undermined self-determination and widespread effects are observed as disparities in health and well-being. Chronic middle ear disease is more highly prevalent in First Nations children, is associated with delays in speech and language and lower levels of educational readiness. However, there is a paucity of culturally and linguistically sensitive speech-language assessments and habilitation services globally. Focussing on high-income colonial-settler countries (including United States, Canada, Australia and New Zealand), where health disparities are significant, we aim to discuss the importance of and the challenges in providing culturally safe care to First Nations children with communication disabilities. RESULT To be effective, both cultural and linguistic diversity and cultural safety must be considered in all aspects of assessment and intervention. Furthermore, speech-language pathologists must be equipped to work with First Nations children with communication disorders. CONCLUSION To optimally support First Nations' children with communication disabilities, services need to be culturally safe, family-centred and strengths-based. This commentary focuses on the United Nations Sustainable Development Goals (SDGs)3, 4, 8 and 10.
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Affiliation(s)
- Andrea Salins
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Macquarie University Centre for Reading, Sydney, Australia
| | - Kai Nash
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Rona Macniven
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia, and
| | - Luke Halvorsen
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Noeleen Lumby
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Catherine McMahon
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- HEAR Centre, Macquarie University, Sydney, Australia
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